Individual provider Active NPI

Kathleen Coppock-Webb, LSW, CSW INTERN

  • Clinical Social Worker
  • Las Vegas, NV
National Provider Identifier
1508273764
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9700-C Issued in NV
Practice address
222 S Rainbow Blvd
Las Vegas, NV 89145-5340
Phone
(702) 884-8495
NPI assigned
Jul 18, 2014
Last updated
Mar 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 9700-C NV Primary

Addresses

Primary practice location

222 S Rainbow Blvd
Las Vegas, NV 89145-5340

Mailing address

222 S Rainbow Blvd
Las Vegas, NV 89145-5340
Phone (702) 884-8495

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
9700-CNVMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Victory Alliance LLC Clinical Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1405641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1508273764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 S RAINBOW BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891455340",
            "telephone_number": "702-884-8495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 S RAINBOW BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891455340",
            "telephone_number": "702-884-8495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPPOCK-WEBB",
        "first_name": "KATHLEEN",
        "credential": "LSW, CSW INTERN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-18",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "9700-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.